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Hand X-rays: The Superpower SupertoolBy Sarah Lisovich|February 12th, 2016|0 Comments Hand X-ray OriginIf you had X-ray vision, what would you choose to study? How about something as simple and yet complex as your own hand? That is what German physicist Wilhelm Röntgen chose after discovering highly energetic electromagnetic radiation, better known as X-rays. The finding came in 1895 and only a year later Glasgow opened a radiology department, where doctors took a look at kidney stones and foreign objects lodged in children’s throats, all while keeping their bodies in tact: a revelation. Although doctors no longer had to cut open the body to see what was on the inside, the then X-raying process was nowhere near as convenient as it is today. In the 19th century, the radiation dosage was 1,500 times greater than it is today, leaving patients with radiation burns and hair loss, and the doctor’s visit was no walk in the park, either. While today’s scans take a whole 20 milliseconds out of your day, technology of the 1890s took closer to 90 minutes but the trials and tribulations were worth the existence and progress of of one of the medical world’s greatest tools. Unfortunately, the history of Röntgen’s discoveries and how they came about is left up to claims and accounts, as his records were burned after his death upon request. Wilhelm Rontgen radiographic image of his wife’s left with her wedding ring on December 22, 1895, shortly after his discovery of X-rays. NATIONAL LIBRARY OF MEDICINE Today, an X-ray of your hand will reveal a black and white image of the bones and soft tissues that get your fingers going. By taking a look inside through this noninvasive procedure, doctors are able to find fractures, injuries, or other issues such as degenerative diseases that take shape in the hand.
How to prepare?If you are planning on getting an X-ray of the hand, the preparation required is minimal. Eating, sleeping, and drinking will have no effects on the results. Simply remove jewelry and accessories from your hands, as to not obstruct the sight of bones and make hand manipulation more accessible for the picture taking process. If you are experiencing swelling in the hand and are not capable of removing the jewelry, the image might be blocked but the X-ray test and process will not be affected. Be sure to notify the technician if you are pregnant, or think you may be pregnant. Radiation exposure might have an affect on the fetus, though the risks are slim, as the radiation exposure is the least amount necessary to produce an image. A protective apron that is lined with lead may be given to you through the duration of the X-ray to women and children to protect sensitive organs. The exposure of radiation is just about one second and risks are minimal. Researchers believe that diagnostic benefits highly outweigh the brief exposure. The procedureThe hand is stationed in various positions on an examination table, as pictures are taken. The image is captured with electromagnetic radiation that passes through the body. The X-ray process on its own is not a painful one. However, in the case that bone fractures, tumors, or arthritis is present in the hand, pain may or may not be felt. What to do with the hand?In an article published originally on AuntMinnie.com, Dr. Naveed Ahmad explains the radiologic patient positioning techniques for x-ray examinations. Radiographic positioning of the hand Radiographic examination of the hand is performed using posteroanterior (PA), oblique, and lateral projections. The PA projection is the best conventional view for demonstrating malalignment, joint-space narrowing, and soft-tissue abnormalities in early rheumatoid arthritis, while the anteroposterior (AP) oblique projection (“ball-catcher” position) is commonly used to look for early evidence of rheumatoid arthritis at the second through fifth proximal phalanges and metatarsophalangeal (MP) joints. Both hands are generally exposed, with the contralateral image used for bony structure comparison. Technical factors
Positioning for PA projection
Positioning for PA oblique projection
Evaluation criteria
Positioning for AP oblique projection (ball-catcher position)
Evaluation criteria
Radiographic positioning of the wrist The routine radiographic examination of the wrist uses the frontal and lateral projections. The PA radiograph is best obtained with the arm abducted 90° from the trunk and the forearm flexed at 90° to the arm. For the evaluation of arthritis, oblique projections also are necessary. These latter projections should include radiographs exposed with the wrist in both a semipronated oblique and a semisupinated oblique position. Technical factors
Positioning for PA wrist projection
Positioning for AP wrist projection
Evaluation criteria for AP and PA wrist
Positioning for PA oblique projection of wrist
Evaluation criteria
Positioning for lateral projection
Evaluation criteria
Positioning for AP oblique wrist projection (medial rotation)
Evaluation criteria
Positioning for PA projection wrist with ulnar deviation (flexion)
Positioning for PA projection wrist with radial deviation (flexion)
Evaluation criteria
Positioning for scaphoid carpal bone (PA wrist axial projection)
Evaluation criteria
By Dr. Naveed Ahmad ResultsIn the case of an emergency (a broken wrist, for example), most modern X-ray machines are able to display results instantly. When reading the image, keep in mind that bones and other dense objects show up white, while soft tissues are gray, and spaces between joints are black. If the results are not urgent and the purpose of the X-ray is to reveal and understand growth patterns, the results may be read within one to two days. About the Author: Sarah LisovichSarah Lisovich is a Chicago based writer, editor, and content strategist at CIA Medical. The young author has published writing on multiple print and online publications and has received the Marion and David Stocking Prize for nonfiction writing. With creative writing, communications and marketing, and public relations experience, the up and coming creative thrives in multimedia publications and looks forward to applying her skills to learn, explore, and write about the wonderful world of medicine. Which position will open the interspaces between the medial carpals?Radial deviation opens the interspaces between the carpals on the medial side of the wrist.
What projection of the wrist will open the interspaces between the carpal on the medial side of the wrist?The PA projection with radial deviation best demonstrates the interspaces on the ulnar side of the wrist between the lunate, triquetrum, pisiform, and hamate bones.
Which projection best demonstrates the carpal interspaces?Upper Extremeties. Which special projection of the wrist will open up the interspaces on the ulnar medial side of the wrist?Chapter 5. |